围术期应用维生素C对预防心脏外科术后房颤疗效的Meta分析  

The effect of perioperative application of vitamin C on the prevention of atrial fibrillation postcardiac surgery:a meta analysis of randomized controlled trials

作　　者：杜欣欣[1] 李建[1] 于湘友[1] DU Xinxin;LI Jian;YU Xiangyou(Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2020年第6期821-826,共6页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区教育厅高校科研计划自然科学重点项目(XJEDU2018I011)。

摘　　要：目的系统评价围术期应用维生素C对预防心脏外科术后房颤的疗效。方法用计算机检索中国知网、中国生物医学文献数据库、维普数据库、万方医学数据库、PubMed、Springer、Embase、Web of Science、Cochrane数据库自建库以来至2019年6月关于接受心脏外科手术的患者围术期应用维生素C的随机对照试验。由2名研究人员分别进行文献筛选、数据提取和质量评价,应用Rev Man 5.2软件对符合标准的文献进行Meta分析。结果共纳入13篇文献,共有患者1671例,其中试验组803例,对照组868例。Meta分析结果显示:试验组术后房颤发生率低于对照组,差异有统计学意义[OR=0.44,95%CI(0.35,0.55),Z=6.95,P<0.00001]。试验组重症监护病房住院(intensive care unit,ICU)时间[MD=-0.21,95%CI(-0.27,-0.14),Z=5.97,P<0.00001]和住院时间[MD=-1.06,95%CI(-1.13,-0.99),Z=30.45,P<0.00001]低于对照组,差异有统计学意义。漏斗图显示纳入文献分布基本对称,提示发表偏倚较小。结论围术期应用维生素C可降低接受心脏外科手术的患者术后房颤发生率,缩短患者ICU住院时间和住院时间。Objective To systematically evaluate the effect of perioperative application of Vitamin C on the prevention of atrial fibrillation postcardiac surgery.Methods Randomized controlled trials about perioperative application of Vitamin C for cardiac surgery patients were searched in CNKI,CBM,VIP database,Wanfang database,PubMed,Springer Link,Embase,Web of Science,Cochrane Library from their inception to June,2019.Two investigators were responsible for literature screening,data extraction and quality evaluation respectively.Meta-analysis was performed with Rev Man 5.2 software.Results A total of 13 references were enrolled and 1671 patients were included(803 patients in intervention group and 868 in control group).Meta analysis showed that the incidence of atrial fibrillation postcardiac surgery was lower in the intervention group than in the control group[OR=0.44,95%CI(0.35~0.55),Z=6.95,P<0.00001].The length of intensive care unit(ICU)stay[MD=-0.21,95%CI(-0.27^-0.14),Z=5.97,P<0.00001]and hospital stay[MD=-1.06,95%CI(-1.13^-0.99),Z=30.45,P<0.00001]in the intervention group were less than in the control group.The funnel plot showed that there was less publication bias among studies.Conclusion Perioperative application of Vitamin C could reduce the incidence of atrial fibrillation postcardiac surgery and reduce the length of ICU stay and hospital stay.

关 键 词：维生素C 心脏外科 房颤 META分析 

分 类 号：R654.2[医药卫生—外科学]